Rigid Gas-Permeable Semi-Scleral Contact Lenses after Radial Keratotomy: Apical Space, Lens Diameter, Limbal Clearance, Peripheral O-Rings, and Tear Exchange as Contact-Lens-Fitting Success Factors

Abstract

The purpose of this case report is to verify if the adaptation of a rigid gas-permeable contact lens can improve VA and comfort in a patient with complications derived from radial keratotomy (RK) surgery. A semi-scleral contact lens was fitted in a 46-year-old female patient who had undergone bilateral RK before 30 years. The uncorrected distance visual acuity in the right eye (RE) and left eye (LE) was 0.5 and 0.6 logMAR (minimum angle resolution), respectively. The RE and LE manifest refractions were +2.00 − 4.25 × 155 diopters (D) and +2.00 − 3.00 × 15 D, respectively. A semi-scleral rigid gas-permeable Rose K2 XL™ lens was fitted in both eyes. The central clearance was 400–450 µm in the RE and 300–350 µm in the LE. The semi-scleral corrected distance visual acuity in the RE and LE was 0.1 and 0.16 logMAR, respectively. Semi-scleral contact lenses are comfortable and a beneficial choice for patients after RK when associated with visual problems and intolerance to other therapeutic options. Semi-scleral lenses permit prolonged duration of use without discomfort, adverse alterations, and improve the feeling of glare in scotopic vision. In the present case, there were multiple factors that influenced the resolution, such as the amount of apical space, lens diameter, limbal clearance, peripheral O-rings, and tear exchange.

Keywords

• radial keratotomy
• scleral lens
• contact lens
• refractive surgery